[Parotid gland sialolithiasis: a new therapeutic option]

In chronic lithiasis of the salivary glands surgery is the only approach available whenever the stone cannot be removed by dilating or dissecting the salivary duct. The introduction of lithotripsy in the treatment of kidney and gall stones has made it possible to apply this method to salivary gland stones as well. The present study was aimed at evaluating the safety, reliability and effectiveness of lithotripsy in 36 patients with symptomatic parotid gland stones which could not be removed by conservative surgery. Ultrasound revealed the stones which were on the average 4.8 mm. In 147 cases they were located in the intraparenchymal area while the remaining 19 cases were located within the duct. No patient required anesthesia, sedative or analgesic. The average number of sessions per patient was 3.8 and each treatment lasted an average of 30 minutes. After lithotripsy, in all 10 of the patients who had completed the treatment, the stone was either totally eliminated or reduced enough to allow for spontaneous elimination. The side effects found in 9 of the patients were minor pain (2 patients), a transitory duct hemorrhage (6 patients) and skin petechia (4 patients). No damage to the salivary glands or adjacent anatomical structures was revealed upon treatment or later during the 10 month average follow up (range 1-22 months). Extracorporeal lithotripsy is a safe, effective, non-invasive alternative therapeutic option for the treatment of parotid sialolithiasis.